Confusion has its uses

Are you shy? Introverted? Reserved? Hostile? Easily bored? Hypercritical? Tightly wound? Quarrelsome? High maintenance? Have you considered medication? It could be that KlineGlasgowSmith has just the pill for you. Do you have restless legs? A limp dick? Flat hair? Do you get hungry several times a day? Do you scratch a lot? You could have a treatable syndrome: please turn on your tv, and the right ad for your condition will appear sooner than you expect.

Frederick Crews looks at the wonderful interplay between Big Pharma and middle-class hypochondria.

Most of us naively regard mental disturbances, like physical ones, as timeless realities that our doctors address according to up-to-date research, employing medicines whose appropriateness and safety have been tested and approved by a benignly vigilant government. Here, however, we catch a glimpse of a different world in which convictions, perceived needs, and choices regarding health care are manufactured along with the products that will match them…Clearly, the drug companies’ publicists couldn’t exercise their consciousness-shaping wiles so fruitfully without a prior disposition among the populace to strive for self-improvement through every legal means…Americans have required little prodding to believe that a medication can neutralize their social handicaps and supply them with a better personality than the one they were dealt by an inconsiderate fate.

See, that’s where I elude their clutches; I’ve never wanted a better personality, even though I would never describe my personality as the ideal personality for everyone to aspire to. I just happen to like mine, that’s all. I like being grouchy and surly and difficult; it suits me; I’m used to it. I’m bemused by people who want to be warmer and more gregarious. What an odd thing to want, I always think, pounding another nail into the board over the window.

I didn’t know about this though – drug companies concealed the side effects of SSRIs and argued in court that there was insufficient evidence for them – until –

Eli Lilly bought the marketing rights to a near relative of its own patent-lapsed Prozac. According to the new drug’s damning patent application, it was less likely than Prozac to induce “headaches, nervousness, anxiety, insomnia, inner restlessness…, suicidal thoughts and self mutilation”.

Fascinating, isn’t it? Deny the side effects until the patent lapses and it’s time to sell a new one, and then mention the side effects. Don’t I feel clever and vindicated for having no urge to take pills to make me Nicer.

Then there’s the way the DSM is geared to validating ‘disorders’ so that psychiatrists can treat them and insurance companies will treat them. (This is US of course, not relevant to other places.)

As for psychiatry’s inability to settle on a discrete list of disorders that can remain impervious to fads and fashions, that is an embarrassment only to clear academic thinkers like these two authors. For bureaucratized psychological treatment, and for the pharmaceutical industry that is now deeply enmeshed in it, confusion has its uses and is likely to persist.

Great phrase, that: confusion has its uses. It does indeed.

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